Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Lysander Jim, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1457642795

Dr. Lysander Jim, MD is a Student in an Organized Health Care Education/Training Program in Pasadena, California. Licensed in California. Registered with an NPI since 2011.

Licensed in
CA
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

452 N Altadena Dr Unit 200
Pasadena, CA 91107-2536
Phone: (626) 838-5485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence A124122 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1457642795
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2011
Last updated in NPPESMarch 21, 2017
Mailing address601 Camino Verde, South Pasadena, CA 91030-4139

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